Velocity of Radial Expansion of Contrast-enhancing Gliomas and the Effectiveness of Radiotherapy in Individual Patients: a Proof of Principle

K. R. Swanson, H. L.P. Harpold, D. L. Peacock, R. Rockne, C. Pennington, L. Kilbride, R. Grant, J. M. Wardlaw, E. C. Alvord

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Abstract

Aims: The initial aims were to use recently available observations of glioblastomas (as part of a previous study) that had been imaged twice without intervening treatment before receiving radiotherapy in order to obtain quantitative measures of glioma growth and invasion according to a new bio-mathematical model. The results were so interesting as to raise the question whether the degree of radio-sensitivity of each tumour could be estimated by comparing the model-predicted and actual durations of survival and total numbers of glioma cells after radiotherapy. Materials and methods: The gadolinium-enhanced T1-weighted and T2-weighted magnetic resonance imaging volumes were segmented and used to calculate the velocity of radial expansion (v) and the net rates of proliferation (ρ) and invasion/dispersal (D) for each patient according to the bio-mathematical model. Results: The ranges of the values of v, D and ρ show that glioblastomas, although clustering at the high end of rates, vary widely one from the other. The effects of X-ray therapy varied from patient to patient. About half survived as predicted without treatment, indicating radio-resistance of these tumours. The other half survived up to about twice as long as predicted without treatment and could have had a corresponding loss of glioma cells, indicating some degree of radio-sensitivity. These results approach the historical estimates that radiotherapy can double survival of the average patient with a glioblastoma. Conclusions: These cases are among the first for which values of v, D and ρ have been calculated for glioblastomas. The results constitute a 'proof of principle' by combining our bio-mathematical model for glioma growth and invasion with pre-treatment imaging observations to provide a new tool showing that individual glioblastomas may be identified as having been radio-resistant or radio-sensitive.

Original languageEnglish (US)
Pages (from-to)301-308
Number of pages8
JournalClinical Oncology
Volume20
Issue number4
DOIs
StatePublished - May 1 2008

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Keywords

  • Bio-mathematical model
  • glioblastoma
  • invasion
  • proliferation
  • radiation therapy
  • radio-sensitivity

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

Swanson, K. R., Harpold, H. L. P., Peacock, D. L., Rockne, R., Pennington, C., Kilbride, L., Grant, R., Wardlaw, J. M., & Alvord, E. C. (2008). Velocity of Radial Expansion of Contrast-enhancing Gliomas and the Effectiveness of Radiotherapy in Individual Patients: a Proof of Principle. Clinical Oncology, 20(4), 301-308. https://doi.org/10.1016/j.clon.2008.01.006